Matoba Munetaka, Tonami Hisao, Kondou Tamaki, Yokota Hajime, Higashi Kotaro, Toga Hirohisa, Sakuma Tutomu
Department of Radiology, Kanazawa Medical University, Kahoku, Ishikaw, Japan.
Radiology. 2007 May;243(2):570-7. doi: 10.1148/radiol.2432060131. Epub 2007 Mar 30.
To prospectively evaluate diffusion-weighted (DW) magnetic resonance (MR) imaging with a split acquisition of fast spin-echo signals for diffusion imaging (SPLICE) sequence for tissue characterization of lung carcinomas by using apparent diffusion coefficients (ADCs).
An institutional review board approved this study; informed consent was obtained from patients. Thirty patients (nine women, 21 men; mean age, 68.0 years) with lung carcinoma underwent DW MR imaging with the SPLICE sequence. ADC of each lung carcinoma was calculated from DW MR images obtained with low and high b values. ADCs of lung carcinomas were statistically compared among histologic types. Nine surgically excised lung carcinomas were evaluated for correlation between ADCs and tumor cellularities. Analysis of variance was used to determine changes in ADCs and histologic lung carcinoma types. Spearman rank correlation was calculated between ADCs and tumor cellularities.
ADCs for lung carcinomas were 1.63 x 10(-3) mm(2)/sec +/- 0.5 (mean +/- standard deviation) for squamous cell carcinoma, 2.12 x 10(-3) mm(2)/sec +/- 0.6 for adenocarcinoma, 1.30 x 10(-3) mm(2)/sec +/- 0.4 for large-cell carcinoma, and 2.09 x 10(-3) mm(2)/sec +/- 0.3 for small-cell carcinoma. ADC of adenocarcinoma was significantly higher than that of squamous cell carcinoma and large-cell carcinoma (P < .05). ADCs were 1.59 x 10(-3) mm(2)/sec +/- 0.5 and 1.70 x 10(-3) mm(2)/sec +/- 0.4 for moderately and poorly differentiated squamous cell carcinoma, respectively. ADCs were 2.52 x 10(-3) mm(2)/sec +/- 0.4 and 1.44 x 10(-3) mm(2)/sec +/- 0.3 for well- and poorly differentiated adenocarcinoma, respectively. ADC of well-differentiated adenocarcinoma was significantly higher than that of moderately and poorly differentiated squamous cell carcinoma and poorly differentiated adenocarcinoma (P < .05). With the Spearman rank test, ADCs of lung carcinomas correlated well with tumor cellularities (Spearman coefficient, -0.75; P < .02).
ADCs of lung carcinomas overlap, but ADCs of well-differentiated adenocarcinoma appear to be higher than those of other histologic lung carcinoma types.
前瞻性评估采用快速自旋回波信号分割采集的扩散加权磁共振成像(DW-MR)的扩散成像(SPLICE)序列,通过表观扩散系数(ADC)对肺癌进行组织特征分析。
本研究经机构审查委员会批准;患者均签署知情同意书。30例肺癌患者(9例女性,21例男性;平均年龄68.0岁)接受了SPLICE序列的DW-MR成像检查。根据低b值和高b值获得的DW-MR图像计算各肺癌的ADC值。对不同组织学类型肺癌的ADC值进行统计学比较。对9例手术切除的肺癌进行ADC值与肿瘤细胞密度相关性评估。采用方差分析确定ADC值和组织学肺癌类型的变化。计算ADC值与肿瘤细胞密度之间的Spearman等级相关性。
鳞状细胞癌的肺癌ADC值为1.63×10⁻³mm²/sec±0.5(平均值±标准差),腺癌为2.12×10⁻³mm²/sec±0.6,大细胞癌为1.30×10⁻³mm²/sec±0.4,小细胞癌为2.09×10⁻³mm²/sec±0.3。腺癌的ADC值显著高于鳞状细胞癌和大细胞癌(P<0.05)。中分化和低分化鳞状细胞癌的ADC值分别为1.59×10⁻³mm²/sec±0.5和1.70×10⁻³mm²/sec±0.4。高分化和低分化腺癌的ADC值分别为2.52×10⁻³mm²/sec±0.4和1.44×10⁻³mm²/sec±0.3。高分化腺癌的ADC值显著高于中分化和低分化鳞状细胞癌以及低分化腺癌(P<0.05)。采用Spearman等级检验,肺癌的ADC值与肿瘤细胞密度相关性良好(Spearman系数为-0.75;P<0.02)。
肺癌的ADC值存在重叠,但高分化腺癌的ADC值似乎高于其他组织学类型的肺癌。